Total Pancreatomy for Carcinoma of the Ampulla of Vater with Aplasia of the Pancreas and Common Hepatic Artery Originating from the Hepatomesenteric Trunk and Running through the Pancreatic Head

A 79-year-old woman was referred to our hospital with carcinoma of the ampulla of Vater．CT showed a hepatic artery branching from the superior mesenteric artery and passing through the pancreatic head. Aplasia of the pancreas was also revealed. Gastrointestinal fiberscopy revealed a tumor spreading...

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Published inThe Japanese Journal of Gastroenterological Surgery Vol. 47; no. 11; pp. 675 - 682
Main Authors Ito, Atene, Kawamoto, Kazuyuki, Yasuchika, Kentaro, Park, Taebun, Ito, Tadashi
Format Journal Article
LanguageJapanese
Published The Japanese Society of Gastroenterological Surgery 01.11.2014
Subjects
aplasia of the pancreas
hepatomesenteric trunk
total pancreatomy
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Summary:A 79-year-old woman was referred to our hospital with carcinoma of the ampulla of Vater．CT showed a hepatic artery branching from the superior mesenteric artery and passing through the pancreatic head. Aplasia of the pancreas was also revealed. Gastrointestinal fiberscopy revealed a tumor spreading from the ampulla of Vater towards the anus. Adenocarcinoma was confirmed by biopsy and total pancreatomy was undertaken. Intraoperatively, the hepatic artery in the pancreatic parenchyma and the spleen were preserved. Histologically, the tumor was a moderately differentiated tubular adenocarcinoma, pT1, N0, M0, fStage I, R0. Aberrant hepatic arteries are often encountered and must be carefully handled in surgery of the pancreas head area, to preserve hepatic blood flow and achieve surgical objectives.
ISSN:0386-9768
1348-9372
DOI:10.5833/jjgs.2014.0019